Test people for infections as they enter prison, says NICE

NICE has published a draft standard aiming to address the variation in health checks offered by prisons in England.

The draft quality standard says healthcare staff working in prisons should offer testing for blood-borne viruses like hepatitis B and C, and HIV to people upon entry to prison. And they should also assess inmates for their risk of having a sexually transmitted infection (STI).

Professor Gillian Leng, deputy chief executive at NICE, said: “Prison is a restrictive environment, which can make it a challenge when it comes to providing healthcare. However, the prison reception can also offer us an opportunity to reach people who have an increased risk of illness and may otherwise slip through the cracks.”

A report published by the Chief Medical Officer in 2012 found 14% of people in prison have hepatitis C compared with 3% of the general population.

Despite this there is variation hepatitis C services provided by prisons in England. An audit carried out by the Health Protection Agency’s Prison Infection Prevention team in 2012 reported only 62% of English prisons had a hepatitis C testing policy.

And testing people in prison for hepatitis C remains low with Public Health England estimating only 11.5% of people entering an English prison in 2014/15 were tested for the virus.

There are no direct estimates for the prevalence of STIs in English prisons. HMP Wormwood scrubs in London found 12% of their inmates tested positive for Chlamydia between 2011 and 2013. However, the test population was low (124 people chose to be tested out of the 1,133 entering the prison) meaning the figure could be much higher.

Professor Leng added: “Identifying people who are entering prison with an infection will mean staff can provide the right treatment as quickly as possible. This will not only mean better care for the person who is infected, but it will also reduce the chances of them passing it on to their fellow inmates and to the wider population when they leave prison.”